The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses最新文献

Abstract: BACKGROUND: Thrombolytic therapy is an effective intervention for acute ischemic stroke. However, the timely administration of this treatment can be hindered by delayed decision-making on the part of family members. Little is known about the reasons for their delay in making decisions. METHODS: This qualitative interview study used face-to-face, individual, semistructured interviews with 16 participants from 2 tertiary hospital neurology wards in Guangdong, China. The interviews were analyzed using inductive content analysis, and descriptive statistics were used to summarize participants' characteristics. RESULTS: Three main themes emerged: a large family communication network, struggling with bleeding risk, and seeking distance treatment advice. CONCLUSION: In China, family members make decisions on behalf of patients and are affected by various factors in the decision-making process, resulting in delayed decision-making. They may experience psychological conflicts when deciding whether to permit thrombolysis, and they tend to seek information from external sources without understanding thrombolysis. Healthcare professionals caring for stroke patients eligible for thrombolytic therapy should provide decision-making support programs tailored to the specific needs of these family members to reduce delayed decision-making.

Abstract: BACKGROUND : Nurses who obtain voluntary specialty certification have higher levels of perceived value for certification compared with noncertified nurses. By identifying and fostering the lesser held perceived values, peers and organizations may increase the overall perceived value of certification among noncertified neuroscience nurses, which, in turn, could lead to higher certification attainment. METHODS : This was a cross-sectional descriptive exploratory design after a survey completed by noncertified neuroscience nurses. Certified neuroscience (CNRN) and stroke certified registered nurses (SCRN) were used as a comparison group. The nurses reported the benefits of certification using the Perceived Value of Certification Tool 12. Logistic regression was used to determine the presence of significant differences in value statement responses among the 2 groups. Percentage of agreement with the value statements among noncertified nurses was also reported. RESULTS : A total of 338 noncertified neuroscience nurses completed the survey. Participants reported a mean age of 44.7 years, and 88% were female. About 68% of participants were White/Non-Hispanic. Among the 12 value statements, noncertified neuroscience nurses reported the highest levels of agreement with statements related to validation of knowledge, personal accomplishment, and commitment to neuroscience nursing. The lowest levels of agreement were associated with being listened to, professional autonomy, and higher pay. Logistic regression demonstrated that certified neuroscience nurses (n = 640) had significant higher levels of agreement with 8 of the 12 value statements compared with noncertified neuroscience nurses . CONCLUSION : Support for certification among neuroscience nurses cannot rely upon 1 source. Although hospitals and professional organizations play a significant role, peer support from certified neuroscience nurses is needed for fostering the value of certification. Further research using open-ended questions to provide detail regarding noncertificant responses to the 8 value statements may provide additional insight needed to strategize certification achievement.

Abstract: BACKGROUND : Epilepsy centers and epilepsy monitoring units (EMUs) specialize in the care of individuals with epilepsy, often requiring patients to undergo evaluations that may increase their risk of injury or status epilepticus. The National Association of Epilepsy Centers has established an accreditation framework for these centers, which includes epilepsy-specific training for nurses in level 3 and 4 facilities. The American Association of Neuroscience Nurses (AANN) launched a certificate program for the seizure and epilepsy healthcare professional, addressing this educational requirement. This study assessed the effects of the AANN epilepsy certificate on nursing knowledge and self-reported confidence in delivering care in an EMU. METHODS : This prospective cohort study involved 39 neuroscience nurses who completed a 20-item knowledge assessment and self-reported measures of knowledge and confidence using a Likert scale before and after completing the AANN epilepsy certificate, followed by 2 additional evaluations. RESULTS : The mean scores on the epilepsy knowledge check increased from 12.3 to 16.1 ( P < .001). This improvement in knowledge was correlated with the highest terminal degree attained ( P = .046), but not with years of experience, time spent in neurology, pediatric nurse certification, or the frequency of work in the EMU. In addition, self-reported confidence scores rose from 19.0 to 22.1 ( P < .001). Based on chart review of the 2 months before and after completion of the modules, the time from seizure identification to seizure treatment decreased from a mean of 6.5 to 4 minutes. CONCLUSION : The completion of the AANN certificate program enhanced the epilepsy-related knowledge and confidence of neuroscience nurses. These educational modules help to meet accreditation requirements for epilepsy centers and provide substantial benefits for nurses.

Abstract: BACKGROUND: The purpose of this study is to examine factors affecting functional improvement among survivors of stroke during the initial months of stroke recovery. METHODS: A 1-group repeated measures sequential mixed methods design was used. Quantitative longitudinal data were collected on admission, discharge, and postdischarge from the inpatient rehabilitation unit to evaluate the change in patient engagement and the relationship between environmental, personal, and behavioral factors, and functional independence. Semistructured interviews were conducted up to 6 months postdischarge. RESULTS: The sample included 27 participants with a mean age of 64.67 (SD = 13.56). There was a significant increase in patient engagement from admission to discharge ( P < .0001), followed by a nonsignificant decrease from discharge to follow-up ( P = .36). The change in functional improvement from admission to discharge was significant ( P < .0001). Stroke severity was the only significant predictor of functional improvement ( P = .008). There was a significant but weak negative correlation between Patient Health Engagement scale (PHE-s®) total score and sleep disturbance ( r = -0.344, P = .008) and sleep disturbance and self-efficacy ( r = -0.362, P = .005). There was a moderate positive correlation between PHE-s total score and self-efficacy ( r = 0.662, P < .001). Five participants participated in follow-up interviews. The 5 main themes that emerged from interview data were (1) feeling happy to be home, (2) wishing recovery was quicker, (3) living with disability, (4) overcoming obstacles, and (5) social support. CONCLUSION: This pilot study provides insight into the experiences of survivors of stroke during rehabilitation and recovery. The results of this study indicate a need for additional support (eg, transportation, social/emotional) for survivors of stroke after discharge from the rehabilitation unit. Further research to investigate the barriers and facilitators of recovery for survivors of stroke after discharge and the development of interventions aimed at improving sustainable recovery outcomes is needed.

Abstract: BACKGROUND: Status epilepticus is an emergency, and applying electroencephalography (EEG) monitoring is an important part of diagnosing and treating seizure. The use of rapidly applied limited array continuous EEG (rapid EEG) has become technologically feasible in recent years. Nurse-led protocols using rapid EEG as a point-of-care monitor are increasingly being adopted. METHODS: A virtual summit meeting of nurses and physicians was convened to discuss various technological and practical aspects of rapid EEG, including the use of nurse-led protocols using rapid EEG. After oral presentations, participants responded to a survey indicating their level of agreement with key position statements. RESULTS: From the 52 participants who participated in the 2-hour summit, there was a strong agreement with the statement "Bedside nurses can start point-of-care EEG with automated seizure alert software to provide more informed care," with a median Likert score of 5 (completely agree) and an interquartile range of 4 to 5. CONCLUSION: Using rapid EEG to monitor for seizure is a valid and valuable method that falls within the nursing domain. Nurse-driven protocols may provide the opportunity to enhance patient care through early identification of seizures.